Project Summary/Narrative Physician-Level Interventions: What Works to Improve Quality of Care? Since the Institute of Medicine published the report Crossing the Quality Chasm in 2001, there has been heightened interest on the part of public and private payers to address quality issues that stem from a U.S. healthcare system widely recognized to be disorganized and uncoordinated. Federal and state governments, as well as private employers by proxy of their health plans, have embraced a number of interventions to enhance quality and curb the growth of health care spending, such as pay-for-performance, public reporting, and the patient-centered medical home. In recent years, an increasing number of these interventions have targeted physicians, given their central role in driving medical decision making, with implications for both cost and quality. Additionally, these types of interventions are included in the Affordable Care Act (March 2010), and are anticipated to be part of the implementation plans for the recently introduced National Quality Strategy (March 2011). This project - Physician-Level Interventions: What Works to Improve Quality of Care? - aims to examine and evaluate the efficacy of various clinician-directed quality interventions and to inform future strategies and decisions of public and private payers and peer regulators. To achieve this aim, the project will produce an initial document within the first six months that begins to describe what we know (and don't know) about a set of well-defined market, regulatory, and professional standard setting interventions targeting practicing clinicians. This initial research will be used to inform the conference to be held at the midpoint in the grant year. The invitation-only conference of policy makers, private sector leaders, and researchers will discuss and debate the implications of this emerging, though not yet complete, evidence summary. The conference will also provide a forum for a substantive conversation about whether the strategies to enhance physician performance continue to provide the best approaches and opportunities to advance reform of the healthcare system as it relates to medicine. By the end of the grant year, the goal is to produce an evidence summary, informed by the conference discussion, and to publish this summary in a peer-reviewed journal read widely by policymakers in order to more broadly disseminate the results to the field and to guide and encourage future research that crosses subfields of research. PUBLIC HEALTH RELEVANCE: Project Narrative Physician-Level Interventions: What Works to Improve Quality of Care? There has been an increased interest in addressing quality issues and costs that result from an unorganized and uncoordinated US healthcare system, expected to be advanced further with health care reform. A large number of interventions have targeted physicians, given their central role in driving medical decision making, with its implications for overall health care quality and costs. This project - Physician-Level Interventions: What Works to Improve Quality of Care? - will focus on the development and dissemination of research that examines the evidence related to a targeted number of interventions focused on enhancing physician performance.